1
Q
Parkinson’s Disease
A
- lack of dopamine
- dopamine and acetylcholine: neurotransmitters responsible for balance, muscle coordination
- when dopamine is depleted, you see and appearance of muscle rigidity, tremors, psychomotor retardation
2
Q
Carbidopa-Levodopa (Sinemet)
Indications and MOA
A
- used for Parkinson’s
- Levodopa circulates in the plasma to the blood-brain barrier, where it crosses to be converted by enzymes into dopamine
- Carbidopa inhibits peripheral plasma breakdown of Levodopa, thereby increasing availability of Levodopa at the blood-brain barrier
- best efficacy: take on schedule with food
- best for improving motor impairment
3
Q
Carbidopa-Levodopa (Sinemet)
Caution and Contraindications
A
- avoid in narrow-angle glaucoma
- avoid in patients with major psychiatric disorders
- avoid in patients with malignant melanoma
- caution with patients who have cardiovascular disease
- caution in elderly patients
- risk of neuroleptic malignant syndrome if abruptly stopped
4
Q
Carbidopa-Levodopa (Sinemet)
Adverse Drug Effects
A
- orthostatic hypotension, somnolence, dizziness, headache, depression, nausea, constipation, dyskinesia, HTN, insomnia, abnormal dreams
- neuroleptic malignant syndrome (rare), peripheral neuropathy (rare)
